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HomeMy Public PortalAbout6254 ENCINITA AVE_Building__ 76AB38A CE#6035-B, APPLICATION FOR BUILDING PER IT COUNTY OF LOS ANGELES BuaDl _ DEPARTMENT OF COUNTY ENGINEER ADDR BUILDING AND SAFETY DMSION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN SUPT of BUILDING CROSS ST. DISTRICT N GROUP TYPE F 4 Y, FOR APPLICANT TO FILL IN p l coNST: /f BUILDIN STATISTICAL CLASSIFICATION SEWER MAP ADDRES Bt— PG I CLASS.NO.-L-1 ELL. UNITS � .� LOT NO. AA,,,, ♦ (�gypp• �B/LLOCK ` WATER NOT REQUIREDbil RECEIVED Lj TRACT IWJ A 4Al `6 �{B.7 CERTIFICATE F� :/'� NIGHwnv NO.OF LDGS. NO. /,-lJ� (CIRCLE) STATE MAJOR SECOND, CAL SIZE OF LOT NOW ON LOT USE ZONE SPECIALL Z USE OF CONDITIONS 'EXISTING BLDG. 5 _/ TEL. r OWNER' NO. . S BUILDING YARD HWY ,STREET NAME EXIST. (SETBACK WIDTH ADDRESS f FRONT ITECT TEL. P. L.' oG qO O DA r ARCH6 ENGINEER J i NO: FIDE ADDRESS CA > rINSPECTION RECORD u EL. Z Y gx CONTRACTOR N ,Ir O. 20 ADDRESS I. F .!�•.} . i v 3/yl./6,Z' �/""' �5�;�!'Y'.�fil.YtJ.ySty 'W DESCRIPTION OF WORE z NEW _ ADD ALTER REPAIR DEMOLISH y"' ( Y SQ. FT. A STOR ES NOMO IES SIZE 'fee SUSE OF.TRU4TURE I. E,S S AGNAT PPLIC REDF �; I ') ✓ I 111I-ltfU VALUATION S �/ Z .�Y�✓� G//� ` �� �/ APPROVALS I DATE INSPECTOR'SSIGNATURE FEE $ �J FEE S ; FOFORMS. MATERIAATSION /�^ FRAME: FIRE STOPS. I HEREBY ACKNOWLEDGE THAT'I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. I I. WITH ALL COUNTY ORDINANCES AND STATE L REGULATING GAS VENT DUCTS BUILDING ON ®RTlY THA GOING E WORK 1\ BUILDING EO HEREBY WILL Pl NY PEfl60VIOLA. LATH, INT. TION OF THE LABOR COD - TA F CALIFORNI RELAT- ING TO WORKM '6 C E SIN6 R CE. LATH.EXT. '� p P RMIITTEE OF gOUSE NUMBER RECT AND POSTED %' O//17 /IZ9 < Y/// ADDRESS FINAL i CLYDE N. DIRLAM,PRINCIPAL ST5PCTURAL ENGINEER PLAN CHECK VALIDATION cK M.G. CASH PERMIT VALIDATION CK. M.o. CASK LA009533 % MAR1 3 2 3 D 18.00t, M p LA,1_„9 8 0' b y i';'-R 21 1 D 3 9,C) 0 ' / I DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELESLD {L®� u (�? WM. J. FOX, CHIEF ENGINEER u � `�I FOR OFFICE USE ONLY FOR APPLICANT TO FILL. RJ n n P _ A DISTRICT NO. PLAN CK. NO. PERMIT NO. ADD EBUILDISS ,NG y meLO la. /(/T WWA AA. `� -- 1127� LOCALITY (•11A+ l.t.�D�iJi l.(+L1 CEIVED BY DATE OF APBL. .f DATEISSUED NEAREST I ' • — L -� CROSS ST. BUILDING op /, //��"�� ��� ADDRESS -J (_e>0 �. OWNER ("PIAN . WVLUliI.JJ✓IAI �,l LOCALITY _`J�-�h�JfYl(v MAIL //� //`-PIAArNeJww/ NEAREST r 1 ADDRESS qQ(/-S �, `/ ��II TEL CROSS ST. CITY �(�M/6OJ� (,lµ/ , NO. TLI 'S 31 I 1, FIRE I NO. OF I TYPE GROUP ARCHITECT OR TEL, ZONE PLANE ENGINEER - NO. BLDG. ORD. NO. SETBACK LINE ADDRESS APPROVED j ' [[ ^^TEL./�• BY DATE CONTRACTOR j'j �/L �' IJ�Jm4M+A7 NO. USE APPROVED ' ZONE BY DATE ADDRESS-�4❑_L �pp �I�pµy&_ItA HOUSE NUMBERING LEGAL1 DESCRIPTION I LOT NO. I BLOCK MAP NUMBER -FIELD CHECK BY TRACT NO. ASSIGNED BY DATE NO. OF SLOGS. CORRECTIONS SIZE OF LOT NOW ON LOT USE OF - NO. OF _ EXISTING BLDG. FAW ues DESCRIPTION OF WORK NEW I I ALTERATION I ADDITION - , O REPAIR DEMOLITION I I I _A G SFT. NO. OF SIZE E ROOMSS STORIES Z EXT. WALLG ROOF r COVERING ( COVERING USE OF STRUCTURE o p APPROVALS INSPECTOR'S SIGNATURE DATE 1 HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FOUNDATION: LOCATION PLICATION AND STATE THAT THE INFORMATION GIVEN IB FORMS. MATERIALS CORRECT. I AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME: FIRE STOPS, HERRON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING, BOLTS LAWS REGULATING BUILDING CONSTRUCTION. FURNACE: LOCATION, SIGNATURE OF EII�� N, A . GAS VENT, DUCTS PERMITTER w IW/n4/n 1 LATH, INT. ' ADDRESS ��'""IrI�O�-�PJI /, - AUTHORIZED AGT. /i LL/fX_ /I.1J.V� lJfl. IVH LATH, EXT. - PLASTER, INT. 76AOIEA- DESS 10-60 © FEE PLASTER, EXT. _ _ VALUATION $FEE FINAL �xil 30 ,'fZ I WORKERS'COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self //pper� O D n //�ppp�� �(' MM FOR O �FI��I��,/[��-. O SERO �q/�7� insure, or a certificate of Workers' Compensation Insurance, (r'p��l���LI-1111, 0 �OO I1 V 11 ®0�1 ����D�II V V PIS U�lU l7 11�� or a certified copy thereof (Sec. 3800, Lab. C.) q (�7 COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy NoQby 30�� y Company S+A�'e �U,,\O Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS (7 OL'1-S; ❑ Certified copy is filed with the county building inspec. BUILDING 4 11 - 'tion department. �I/�'�}�� f/ ADDRESS / 5 \ N•• �'�C.\).1'\� Date --L - / Applicant 4, /�LCl/3'� CITY eM `-4P C, ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' - NO. OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT JJ CROSS ST. (This sectionneed not be completed if the permit is for one TRACT BLOCK LOT NO. I ' ASSESSOR hundred dollars ($100)or less.) MAP BOOK PAGE PARCEL TEL' USE ZONE MAP OWNER I certify that in the performance of the work for which this � A � - NO _ �_ � NO. permit is issued, I shall not employ any person in any manner ll �� ) \�, P SPECIAL - dt so as to become subject to the Workers'Compensation Laws. ADOBE'S 1 p CONDITIONS Q CITU n �� C A v ZIP cl! I p O V Date - Appi icont- (r ARCHITECT OR TEL. NOTICE TO APPLICANT: If, offer subject tto Certificate of DISTRICT GROUP TYPE FIRE PROCESSED BY O Exemption, you should become Subject to the Workers' ENGINEER NO. - CONST./ ZONE (-- Compensation,provisions of the Labor Code, you must forth- ADDRESS ✓s It PY, j ✓ W with comply with such. provisions or this.permit shall be 0- deemed deemed revoked. TEL 2 STATISTICAL CIA'$IFICATION APT. CON (n CONTRACTOR C.,Y(.�JA O6FIN NO.U��� �f)� � Z LICENSED CONTRACTORS DECLARATION (� q LIC CLAS'NO. DWELL. UNITS_ I hereby off irm that I am licensed under provisions of Chapter 9 ADDRESS 3 I S P1 CC�P�VI[ NO.'y (commencing with Section 7000)of Division 3 of the Business and LIC 2 'EWER MAP Professions Code, and my license isin full force and effect. CITY COU(7J'A CLAS' C_3 VALIDATION (� I SO. FT. SNT OF NO. Of CHECK License Number. /3 b�3 �' Lic.Clc. SIZE STORIES FAMILIES .ONE - p adv, y�l (� [' VALUATION Contractor CNlrW A4 adv,t, Dote �Z-� 1 DESCRIPTIONOFOF WORK (R�r� O- !((V�� NEW ❑ $VALUATION fPATOU W-0 3A" CPQ RQ JACP ADD ❑ D 1 am exempt under Sec. , /^ ALTER ❑ B.BP.C. for this reason (�aFe�-1-p..p l-. 455 (C Shin. L REPAIR ❑ $ Date: USE OF DEMOL EXISTING BLDG. ❑ Signature APPLICANT TEL. tt FINAL OWNER-BUILDER DECLARATION PRINT ^'��a M�r{s.N NO. 3J S�S DATE I hereby affirm that I am exempt from the Contractors License rQZ U 5/1 �A Lfa PU Pnl'�'Q -478 A Law for the following reason (Section 7031.5, Business and ADDRESS50-1 ' NFINA Professions Code): - PRESENT V 4,` e e e • e ❑ BUILDING # .�• I, as owner of the property, or my employees with ADDRESS wages os their sole compensation,will do the work and ' the structure is not intended or offered for sale(Section LOCALITYT •r° 6 a 6 3 D 7044, Business and Professions Code). MOVING TEL. °�° ° 6 8.6 3.6 I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESSs tion 7044, Business and Professions Code). '� 6 O 2... 8 7 REQUIRED TOTAL SETBACKAWL CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there iso construction lending agency for FRONT the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ.,C.). SIDE P.L. Lender's Name - 3 LDMA R.I. 8 Lender's Address P.C. Fee$ Permit Fee D I certify that I have read this application and state that the Issuance Feat LDMA P/C N above information is correct. I agree to comply with oil County Investigation Fee o ordinances and State laws relating to building construction, `h an eby authorize representatives of this County to enter total Fee V r s/� LDMA Parm. p B u nth above-mpnp d prg operty for inspection purposes. Q�1/, ,LL//I 'oJv'//(/,Ii_j/ �-- 6-2 �p SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date .. . WORKERS'COMPENSATION DECLARATION "'�• s� �• C, I herebKrffirm that I have o certificate of consent to self O O O D Il insure, oracertificate of Workers'Compensation Insurance, APPLOCATOON FOR BURONG PER6UvilOT oro certified copy thereof Sec. 3800, Lob C.) n/fu cV �s 3 dCo pony C/:R COUNTY OF LOS ANGELES BUILDING AND SAFETY P Certified copy is hereby furnished. 0 FOR APPLICANT TO FILL IN BUILDING L/N 17"f� ADDRESS Certified copy is filed with the county building inspec- BUILDING ^ �"'� ) )_ I 'j'' /� �.n lion department. _ ADDRESS G><� G�V�//�J / A LOCALITY G7's�LE I 4fe r / NEAREST Date Applicant ' CITY L G ZIP CRO55 ST. C RTIFI ATE OF EXEMPTION FROM WORKERS' O. OF BLDG$. �^L ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT OL MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE MAP ' hundred dollars ($100)or less.) TRACT BLOCK LOT NO. . NO. Q 13 T A/p TEL. y _ R� / SPECIAL iF } I certify that in the performance of the work for which this OWNER . L - NO.uCr>� CONDITIONS t' S permit is issued, I shall not employ any person in any manner ,d DISTRICT GROUP TYPE FIRE PR ESSF�D BV 0 ADDRESS `' G 7/G CONST. ZONE V so as to become subject to the Workers'Compensation Laws. d /,0 �/ if 3 , / a O CITY E PLS ZIP S E �/ Date Applicant STATISTICAL CLASSIFICATION — 'APT. CONDO. P_ ARCHITECT OR TEL. NOTICE n, APPLICANT: If, after making this Certificate of V Exemption, you should become subject to the Workers' �' ENGINEER NO. CLASS UNITS_ a Compensation provisions of the Labor Code, you must forth- ADDRESS - SEWER MAP with comply with such provisions or This permit shall be /— , � ? deemed revoked. CONTRACTOR 1�J BK. CPG,.Z VALIDATION LICENSED CONTRACTORS DECLARATION UC. 7 I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS &,Jz.c— NO. 1]-�3/ VALUATIO ' (commencing with Section 7000)of Division 3 of the Business and LIC Professions Code, and my license is in full force and effect. CITY /�( AIP,�4 , CLASS $ '�✓ r D SQ. FT. NO.OF NO.OF CHECK License Number 3Za v Llc.Class SIZE 1160 STORIES IF Contract "''. FAMILIIEES ONE r/ ,.� DESCRIPTION OF WORK �l E C EW ❑ S o � ato� - I am exempt under Sec. �[ E 4: ADD ❑ ALTER FINAL 42 B.BP.C. for this reason REPAIR DATE / a Date: USE OF EXISTING BLDG.'. �' �QQ DEMOL ❑ FINAL Signature APPLICANTTEL. L'�� ` OWNER-BUILDER DECLARATION PRINT 16_4,,FNO. q I hereby affirm that I am exempt from the Contractor's License B AGE D �o Z 3 O.b Low for the following reason (Section 7031.5, Business and ADDRESS /, (� Professions Code): PRESENT vl/ - # ° e ° e e 1 ❑ BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and Z'e 1 0 6 1 3 the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. 1 0 6 1 3 I, as owner of the property, am exclusively contracting CONTRACTOR NO. , with licensed contractors to construct the project (Sec- ADDRESS - O 5 27-83 'tion 7044, Business and Professions Cade). REQUIREDTOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT / iphe performance of the work for which this Permit is issued P.l. Z0 C) a d Sec. 3097, Civ. C.). SIDE - P.1. iO 1 O 1 / O GO Lender's Name Lender's Address P.C. Fee$ Permit Fee c I certify that I have read this application and state that the Issuance Fee above information is correct. I agree to comply with.all County Investigation Fee / ordinances and State laws relating to building construction, Total Fee G and hereby authorize representatives of this County to enter u e above-mentiorfa rop'ty for�pection purposes. _ n !' ,'tCO :9 a. SEE REVERSE FOR EXPLANATORY LANGUAGE (�1 Signature of Applicant or A9Vt f DoI6 i